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Disseminated Intravascular Coagulation

WHAT IS DISSEMINATED INTRAVASCULAR COAGULATION?

Disseminated Intravascular Coagulation is a condition in which small blood clots develop throughout the bloodstream, blocking small blood vessels. And this might result in organ damage.

The increased clotting uses up platelets and clotting factors in the blood (platelets are blood cells that stick together to seal small cuts and breaks on the blood vessel walls and stop bleeding; and clotting factors are proteins needed for normal blood clotting). With fewer platelets ad clotting factors in the blood, serious bleeding can occur. DIC can cause internal and external bleeding and can be life-threatening.

There are two types of DIC – Acute and Chronic.

Acute DIC develops quickly (over a few hours or days) and should be treated immediately. The condition begins with excessive blood clotting in the small blood vessels and quickly leads to serious bleeding.

Chronic DIC develops slowly (over weeks or months). It lasts longer and isn’t quickly recognised. Chronic DIC causes excessive clotting but it usually doesn’t lead to bleeding. Cancer is the most common cause of Chronic DIC.

WHAT CAUSES DIC?

There are certain diseases or conditions that can disrupt the body’s normal blood clotting process and that could lead to DIC:

Sepsis (an infection in the bloodstream)

Surgery and trauma

Cancer

Serious complications of pregnancy and childbirth.

Bites from poisonous snakes, frostbite and burns are other less common causes of DIC.

WHAT ARE THE SIGNS AND SYMPTOMS OF DIC?

Chest pain and shortness of breath if blood clots form in the blood vessels in your lungs and heart

Pain, redness, warmth, and swelling in the lower leg if blood clots form in the deep veins of the leg

Headaches, speech changes, paralysis, dizziness, and trouble speaking and understanding if blood clots form in the blood vessels in the brain. It could lead to a stroke.

Heart attack and lung & kidney problems if blood clots lodge in the heart, lungs or kidneys. The organs may even begin to fail.

In DIC, the increased clotting activity uses up platelets and clotting factors in the blood that can lead to serious bleeding. DIC can cause internal and external bleeding.

Signs & symptoms of internal bleeding are:

Blood in the urine from bleeding in the kidneys or bladder

Blood in the stool from bleeding in the intestines or stomach.

Headaches, double vision, seizures and other symptoms from bleeding in the brain.

Signs and symptoms of external bleeding are:

Purple, brown and red bruises (purpura)

Small red or purple dots on the skin (petechiae)

Prolonged bleeding, even from minor cuts

Bleeding or oozing from the gums or nose, especially nosebleeds or bleeding from brushing teeth

Heavy or extended menstrual bleeding in women.

HOW IS DIC DIAGNOSED?

To confirm the diagnosis of DIC, your doctor may recommend the following tests:

Complete Blood Count (CBC) and Blood Smear: CBC measures the number of red blood cells, white blood cells and platelets in the blood. And a Blood Smear is a test that reveals the condition of red blood cells.

Tests for Clotting Factors and Clotting Time: The following tests examine the proteins active in the blood clotting process and how long it takes them to form a blood clot.

PT and PTT Tests – these tests measure how long it takes blood clots to form

Serum fibrinogen – Fibrinogen is a protein that helps the blood clot. This test measures how much fibrinogen is in your blood.

Fibrin degradation – After blood clots dissolve, substances called fibrin degradation products are left behind in the blood. This test measures the amount of these substances in the blood.

HOW IS DIC TREATED?

The treatment for DIC depends on its severity and its cause and the main goals of the treatment are to control bleeding and clotting problems and treat the underlying cause.

People who have Acute DIC may have severe bleeding and requires emergency treatment in a hospital. The treatments may include Blood Transfusions, Medicines and Oxygen Therapy.

A blood transfusion is a safe and common procedure where the patient receives blood through an intravenous line in one of the blood vessels. Blood transfusions are done to replace blood loss due to an injury, surgery or illness. A person suffering from DIC may be given platelets and clotting factors, red blood cells and plasma (the liquid part of the blood).

People who have Chronic DIC are more likely to have blood clotting problems than bleeding and the doctor may treat you with medicines called anticoagulants, or blood thinners. Blood thinners help prevent blood clots from forming and also keep existing blood clots from getting larger.